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This discrepancy might be attributable to methodological factors, such as the testing duration

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Histopathological findings often reveal increased melanin deposition in the epithelial basal layer and may include melanin-laden macrophages within the connective tissue, without a corresponding rise in the number of melanocytes [9]

Importantly, smokers melanosis does not undergo malignant transformation [11, 36]

13 , 14 Although it is reflected in only a few published studies, we believe that genital melanosis is particularly likely to arise from within an area of lichen sclerosus 13 (Fig